Background: An accurate medication history, foundational for providing quality medical care, requires understanding of medication change events documented in clinical notes. However, extracting medication changes without the necessary clinical context is insufficient for real-world applications. Methods: To address this need, Track 1 of the 2022 National NLP Clinical Challenges focused on extracting the context for medication changes documented in clinical notes using the Contextualized Medication Event Dataset. Track 1 consisted of 3 subtasks: extracting medication mentions from clinical notes (NER), determining whether a medication change is being discussed (Event), and determining the action, negation, temporality, certainty, and actor for any change events (Context). Participants were allowed to participate in any one or more of the subtasks. Results: A total of 32 teams with participants from 19 countries submitted a total of 211 systems across all subtasks. Most teams formulated NER as a token classification task and Event and Context as multi-class classification tasks, using transformer-based large language models. Overall, performance for NER was high across submitted systems. However, performance for Event and Context were much lower, often due to indirectly stated change events with no clear action verb, events requiring farther textual clues for understanding, and medication mentions with multiple change events. Conclusions: This shared task showed that while NLP research on medication extraction is relatively mature, understanding of contextual information surrounding medication events in clinical notes is still an open problem requiring further research to achieve the end goal of supporting real-world clinical applications.